Provider Demographics
NPI:1124140355
Name:CHIU, GABRIEL HAM-CHANG JR (DO)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:HAM-CHANG
Last Name:CHIU
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9454 WILSHIRE BLVD
Mailing Address - Street 2:GROUND FLOOR #108
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2929
Mailing Address - Country:US
Mailing Address - Phone:310-888-8087
Mailing Address - Fax:310-246-1910
Practice Address - Street 1:9454 WILSHIRE BLVD
Practice Address - Street 2:GROUND FLOOR #108
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2929
Practice Address - Country:US
Practice Address - Phone:310-888-8087
Practice Address - Fax:310-246-1910
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A86192086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A8619OtherMEDICAL LICENSE NO.
CA20A8619OtherMEDICAL LICENSE NO.